Lamotrigine in treatment of Writer’s cramp (Focal dystonia) in unspecified bipolar and related disorder

Rajnish Raj, Raj Kumar


Writer’s cramp is a focal dystonia and its non-response to a standard treatment regimen prompts review of the diagnosis as unspecified bipolar and related disorder. Mr. X, aged 44 years male, showed a symptom of writer’s cramp and his condition worsened on augmentation with antidepressant and antipsychotic drugs. The diagnosis of unspecified bipolar and related disorder is applied when it clinically impairs social, occupational, or other important areas of functioning that do not meet the full criteria for any of the disorders in bipolar class or when a clinician chooses not to specify the reason that the criteria are not met, and there is insufficient information to make the specific diagnosis. In our case, lamotrigine has shown effectiveness in unraveling writer’s cramp and is suggested as an alternate treatment in unmet need for bipolar disorders because of its pleiotropic actions on the nervous system, e.g., membrane stabilizing, neuronal plasticity, and inhibition of glutamate release.


Writer’s cramp, Unspecified bipolar and related disorders, Lamotrigine, Diagnostic and statistical manual of mental disorders

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